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Mindfulness-based therapy may be more effective than traditional group therapy for PTSD

Mindfulness-based stress reduction therapy led to greater improvement in PTSD symptom severity than present-centered group therapy among veterans with PTSD.

“Evidence suggests that mindfulness-based stress reduction, an intervention that teaches individuals to attend to the present moment in a nonjudgmental, accepting manner, can result in reduced symptoms of depression and anxiety. By encouraging acceptance of thoughts, feelings, and experiences without avoidance, mindfulness-based interventions target experiential avoidance, a key factor in the development and maintenance of PTSD,” study researcher Melissa A. Polusny, PhD, of Minneapolis Veterans Affairs Health Care System, and colleagues wrote.

Melissa A. Polusny

To compare efficacy of mindfulness-based stress reduction and present-centered group therapy for PTSD, researchers randomly assigned 116 veterans with PTSD to receive nine sessions of mindfulness-based stress reduction therapy (n = 58) or nine sessions of present-centered group therapy (n = 58). Mindfulness therapy aimed to teach patients “to attend the present moment in a nonjudgmental, accepting manner,” and was conducted in eight 2.5-hour group sessions and a daylong retreat. Present-centered group therapy focused on current life problems and was conducted in nine weekly 1.5 hour sessions. Change in PTSD symptom severity was assessed via the PTSD Checklist at baseline and weeks 3, 6, 9 and 17.

Compared with participants who received present-centered group therapy, participants who received mindfulness-based therapy had greater improvement in self-reported PTSD symptom severity during treatment (P = .002) and at 2-month follow-up (P < .001).

While participants who received mindfulness-based therapy were more likely to exhibit clinically significant improvement in PTSD symptom severity at 2-month follow-up (P = .03), they were no more likely to lose PTSD diagnosis compared with participants who received present-centered group therapy (53.3% vs. 47.3%; P = .55).

“The quality of scientific evidence supporting the efficacy of mindfulness-based interventions has recently been criticized. This study improves on shortcomings of previous trials by comparing mindfulness-based stress reduction with an active, credible control condition, taking steps to ensure treatment fidelity, and using both patient-reported and blinded clinician ratings of PTSD outcomes,” Polusny and colleagues wrote. “Among veterans with PTSD, mindfulness-based stress reduction therapy, compared with present-centered group therapy, resulted in a greater decrease in PTSD symptom severity. However, the magnitude of the average improvement suggests a modest effect.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.